An unusual case of a tibial metastasis as the first clinical presentation of a serous papillary carcinoma of the ovarian epithelial type of the testis.

Among testicular neoplasms, ovarian-type epithelial tumors constitute an exceedingly rare group, with only a few cases reported in the literature. We describe the case of an 82-year-old man, presented with complaints of right leg pain and difficulty walking, who was found to have a large right tibial metastasis of unknown primary origin. Whole body CT scan did not reveal any cranial, thoracic or abdominal tumor masses, but it showed abnormal para-aortic lymph nodes and right spermatic cord swelling. An extemporary ultrasound examination found a right testicular mass. The patient underwent radical orchiectomy, and the diagnosis of a serous papillary carcinoma of the ovarian epithelial type of the testis was made. To the best of our knowledge, this is the first case in the literature of isolated bone metastasis from ovarian-type epithelial tumor of testis.

Electrochemical Biosensors for Tracing Cyanotoxins in Food and Environmental Matrices.

The adoption of electrochemical principles to realize on-field analytical tools for detecting pollutants represents a great possibility for food safety and environmental applications. With respect to the existing transduction mechanisms, i.e., colorimetric, fluorescence, piezoelectric etc., electrochemical mechanisms offer the tremendous advantage of being easily miniaturized, connected with low cost (commercially available) readers and unaffected by the color/turbidity of real matrices. In particular, their versatility represents a powerful approach for detecting traces of emerging pollutants such as cyanotoxins. The combination of electrochemical platforms with nanomaterials, synthetic receptors and microfabrication makes electroanalysis a strong starting point towards decentralized monitoring of toxins in diverse matrices. This review gives an overview of the electrochemical biosensors that have been developed to detect four common cyanotoxins, namely microcystin-LR, anatoxin-a, saxitoxin and cylindrospermopsin. The manuscript provides the readers a quick guide to understand the main electrochemical platforms that have been realized so far, and the presence of a comprehensive table provides a perspective at a glance.

Locally advanced rectal cancer: qualitative and quantitative evaluation of diffusion-weighted magnetic resonance imaging in restaging after neoadjuvant chemo-radiotherapy.

PURPOSE: To determine the added value of qualitative and quantitative evaluation of diffusion-weighted magnetic resonance imaging (DWI) in locally advanced rectal cancer (LARC) restaging after neoadjuvant chemo-radiotherapy (CRT). MATERIALS AND METHODS: A retrospective study was performed of 21 patients with LARC treated with CRT. All patients were evaluated with 1.5 T conventional magnetic resonance imaging (MRI) and DWI (0-1000 s/mm²) before starting therapy and after neoadjuvant CRT. All included patients underwent surgery after CRT: the histopathological evaluation of surgical specimens represented the reference standard for local staging after neoadjuvant therapy. The qualitative analysis was carried out by two operators in consensus, who reviewed the conventional MR image set [T1-weighted and T2-weighted morphological sequences + dynamic contrast-enhanced sequences (DCE)] and the combined set of conventional and DW images. For the quantitative analysis, the apparent diffusion coefficient (ADC) values were measured at each examination. For each lesion, the mean ADC value (ADCpre and ADCpost) and the ΔADC (ADCpost - ADCpre) were calculated, and values of the three groups of response [complete response (pCR), partial response (pPR), stable disease (pSD)] were compared. RESULTS: In LARC restaging, conventional MRI showed a sensitivity of 80% and a specificity of 50%, with a total diagnostic capacity of 71.40%, while by adding DWI sensitivity increased to 100%, specificity to 67%, and total diagnostic capacity to 90.40%. ΔADC correlates with treatment response and a cutoff of 1.35 × 10-3 mm²/s predicts the pCR with a sensitivity of 93.3% and a specificity of 83.3%. CONCLUSIONS: Adding DWI to conventional sequences may improve MRI capability to evaluate tumor response to CRT. The quantitative DWI assessment is promising, but larger studies are required.

Biparametric MRI of the prostate.

Biparametric Magnetic Resonance Imaging (bpMRI) of the prostate combining both morphologic T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) is emerging as an alternative to multiparametric MRI (mpMRI) to detect, to localize and to guide prostatic targeted biopsy in patients with suspicious prostate cancer (PCa). BpMRI overcomes some limitations of mpMRI such as the costs, the time required to perform the study, the use of gadolinium-based contrast agents and the lack of a guidance for management of score 3 lesions equivocal for significant PCa. In our experience the optimal and similar clinical results of the bpMRI in comparison to mpMRI are essentially related to the DWI that we consider the dominant sequence for detection suspicious PCa both in transition and in peripheral zone. In clinical practice, the adoption of bpMRI standardized scoring system, indicating the likelihood to diagnose a clinically significant PCa and establishing the management of each suspicious category (from 1 to 4), could represent the rationale to simplify and to improve the current interpretation of mpMRI based on Prostate Imaging and Reporting Archiving Data System version 2 (PI-RADS v2). In this review article we report and describe the current knowledge about bpMRI in the detection of suspicious PCa and a simplified PI-RADS based on bpMRI for management of each suspicious PCa categories to facilitate the communication between radiologists and urologists.